On June 26, 2018, Oklahoma voters approved State Question 788, the Medical Marijuana Legalization Initiative, legalizing “the licensed use, sale, and growth of marijuana in Oklahoma for medicinal purposes.”

The state question was written to allow anyone to claim just about any medical need for a card. The ease of access to medical weed made Oklahoma virtually unique among states with similar laws. Politico noted that “Oklahoma is now the biggest medical marijuana market in the country on a per capita basis.”

Head Shops on Every Corner

The dispensaries proliferated rapidly, sometimes more than one on a single block, more than 100 in one ZIP code. The Politico article cited Ardmore with a population of 25,000 and 36 dispensaries—one for every 700 residents.

“Oklahomans like to boast that our state is a good place to raise a family,” OCPA distinguished fellow Andrew Spiropoulos wrote on January 23, 2019. “But would you have chosen to settle in the heart of Oklahoma City if you knew that NW 23rd Street would be planted thick from N. Portland Avenue to N. Broadway with head shops? The monotony of signs advertising marijuana products is only occasionally broken by ads for the lottery or a local casino. We better save some money to help the addicts and broken families we’re about to help create.”

Mark Woodward, spokesman for the Oklahoma Bureau of Narcotics and Dangerous Drugs (OBNDD), said Oklahoma’s medical marijuana law has unintentionally made the state a national center of illegal growing operations.

“We are taking down two or three (grow operations) a week,” he said. “I just came from one in Rush Springs where we found 20 Chinese laborers who were the victims of human trafficking. The owner had them working his grow operation and they had no idea where they were.”

Both legal and illegal growers from other states saw Oklahoma open for marijuana business and compared the costs here with those in their home states and began flocking here in 2020, Woodward said.

“Part of it may have been COVID, but cost is a factor,” he said. “Since last fall we have had a tremendous influx of both legal and criminal organizations setting up grow operations. They are paying three times or more what pieces of land are worth and still coming out ahead.”

A grower who was paying tens of thousands for a license in California, and hundreds of thousands for land, can get an Oklahoma license for $3,000, which is the cheapest in the nation, Woodward said. Oklahoma’s regulations are also looser. That attracts both legal and illegal growers, and some legal ones are actually “ghost” operators with a local front person and actual ownership in China or through a Mexican cartel.

On March 30, 2021, a group of 50 Republican state representatives, led by state Rep. Anthony Moore, R-Clinton, and House Speaker Charles McCall, R-Atoka, sent a letter to Oklahoma Attorney General Mike Hunter “expressing their support for his efforts to work with local and statewide law enforcement to track reported transactions by aliens or foreign entities who acquire title to real property in Oklahoma with an underlying criminal purpose.”

OBNDD gets frequent complaints, Woodward said, from landowners in rural Oklahoma who are concerned with how their property values will be impacted by growers arriving and paying $80,000 for a $20,000 plot of land. There are also worries about the water-hungry plants lowering water tables, and even with power brownouts from greenhouse equipment siphoning from the local power grid.

Woodward said OBNDD agents watched after California legalized medical marijuana in 1996. Advocates of legal drugs had long claimed that once the criminal stigma was removed, the black market would dry up. In fact, Woodward said, the same thing happened there as we are seeing in Oklahoma. Black market drugs are always going to be cheaper with unlimited supplies.

Woodward said most dispensary operators “are trying to do what is right,” but they are being undercut by black market distributors who are benefiting from the large number of both legal and illegal growing facilities.

“Dispensary owners are telling us they can’t compete,” Woodward said.

Woodward said the lax provisions of Oklahoma’s medical marijuana law have effectively given the state legal recreational marijuana, since almost any adult can qualify for a card. He said he is concerned that so many people have bought into the myth that marijuana is a wonder drug, when in fact it has limited and still debatable efficacy for only a small number of medical conditions in some patients.

“We hear from people who have been diagnosed with cancer who read in some obscure magazine that marijuana caused a tumor to shrink in rats,” he said. “So they put their hopes in a drug that cannot help them.”

He said he also worries about the young people who are using the drug recreationally on a frequent basis, despite research that shows the risk of permanent brain damage for those in their age range.

Compounding that concern is the fact that unlike actual prescribed medications, there is no way to regulate the dosage and quality of a given batch of weed. A law passed in 2019 to impose “seed to consumer” monitoring of the product has been stalled by lawsuits from distributors.

Marijuana Use Disorder

And the question remains, is marijuana uniquely harmless among other previously illegal drugs, as many of its backers assert, or is it simply another intoxicating drug with the potential for overuse and addiction?

The National Institute on Drug Abuse (NIDA) and every reputable source in the addiction field recognizes a condition called marijuana use disorder, the symptoms of which closely parallel addiction to other substances like alcohol. NIDA projects that 30 percent or more of users will exhibit some degree of the disorder, and if they start using it before age 18 (which almost all do) their chances of developing full-blown dependency increase from four to seven times.

Most worrisome, multiple studies have shown that heavy marijuana use before age 25 poses an elevated risk of permanently altering brain function, including early onset of psychosis.

According to the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS), marijuana consistently ranks third, behind only methamphetamine and alcohol, when those being admitted for addiction treatment are asked what is their primary drug of abuse. A report by the Oklahoma Bureau of Narcotics cited data showing that 14 percent of all addiction treatment admissions in 2015 were due primarily to marijuana habits.

ODMHSAS spokesman Jeffrey Dismukes said that “according to the Substance Abuse and Mental Health Services Administration, approximately one in 10 people who use marijuana will become addicted. When they start before age 18, the rate of addiction rises to 1 in 6.”

Dismukes noted that today’s marijuana—including that grown for alleged medical uses—contains far more tetrahydrocannabinol (THC, the psychoactive ingredient in the plants) than in previous decades.

“The higher the THC amount, the stronger the effects on the brain—likely contributing to increased rates of marijuana-related emergency room visits and other adverse effects,” Dismukes said. Clinicians are also concerned about how THC might interact with prescribed medications, especially medications like antidepressants.

That is a concern shared by Dr. Jedidiah Perdue, medical director of the Arcadia Trails addiction treatment center in Edmond and a specialist in addiction medicine.

“I have seen many people who need residential treatment for an addiction to cannabis, and we have also seen an increase in people seeking treatment in the past year,” he said. “These were individuals who put themselves at risk of developing an addiction through regular and sustained use of marijuana.”

Dr. Perdue said the cannabis-addicted population has recently shifted from primarily young people to include patients as old as their 40s, many of whom likely acquired the drug through the medical marijuana program.

“I think this is just the tip of the iceberg,” the physician said. “I think we will see more people having trouble with cannabis. We know that between one in eight and one in 10 people who use any addictive drug will develop addiction to it over time.” He suggested that the greater availability of marijuana since legalization will only swell those numbers.

Dr. Perdue said he is also concerned with the proliferation of dispensaries with little or no regulation.

“We limit certain forms of advertising for liquor,” he said, noting that most residents would be concerned with a liquor store on every corner as is often the case with marijuana dispensaries.

The COVID-19 pandemic has also played a role in the upsurge in people seeking treatment for their marijuana addiction, he speculated, noting that the increased availability of marijuana coincided with pandemic lockdowns and stress. “Many people used substances as a way to cope,” he said.

Dr. Perdue said he agrees that there are a limited number of potential uses for THC in medicine, but noted that there are minimal ways to measure dosages in most of the products being sold through dispensaries. Risks from those highly potent forms of THC include psychiatric issues.

“I just recently saw a patient who was suffering from a psychiatric disorder as a result of his heavy marijuana use,” he noted.

There are also dangers to children who are far too young to qualify for a medical marijuana card, but who may ingest some of the edible forms of the drug purchased by parents.

Lynn Casey of the communications and marketing office at Tulsa’s St. Francis Health System said their pediatric emergency room has seen “a startling amount” of children who consumed marijuana gummies or other enticing products. Saint Francis even issued a warning to member physicians noting that “in addition to the more common dizziness, sedation, and hallucinations, (children) can also experience suppressed breathing” that can in more serious cases require the use of a ventilator.

According to a white paper from the National Institute on Drug Abuse, the Food and Drug Administration has approved prescription medications derived from THC to treat nausea experienced by cancer patients receiving chemotherapy. There are also some THC-based products being tested to relieve muscle spasms associated with multiple sclerosis, and for controlling symptoms in forms of childhood epilepsy. These are not raw marijuana; they are legally tested and processed medications to be prescribed by physicians and dispensed from normal pharmacies.

Actual marijuana plants, and even edible products containing them, “may contain hundreds of unknown, active chemicals,” the white paper said, “and it can be difficult to develop a product with accurate and consistent doses of these chemicals. Use of marijuana as medicine also poses other problems such as the adverse health effects of smoking and THC-induced cognitive impairment.”